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Paying the price: the pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners.

ABSTRACT: Despite a recent decline in the U.S. prison population, the older prisoner population is growing rapidly. U.S. prisons are constitutionally required to provide health care to prisoners. As the population ages, healthcare costs rise, states are forced to cut spending, and many correctional agencies struggle to meet this legal standard of care. Failure to meet the healthcare needs of older prisoners, who now account for nearly 10% of the prison population, can cause avoidable suffering in a medically vulnerable population and violation of the constitutional mandate for timely access to an appropriate level of care while incarcerated. Older prisoners who cannot access adequate health care in prison also affect community healthcare systems because more than 95% of prisoners are eventually released, many to urban communities where healthcare disparities are common and acute healthcare resources are overused. A lack of uniform quality and cost data has significantly hampered innovations in policy and practice to improve value in correctional health care (achieving desired health outcomes at sustainable costs). With their unique knowledge of complex chronic disease management, experts in geriatrics are positioned to help address the aging crisis in correctional health care. This article delineates the basic health, cost, and outcomes data that geriatricians and gerontologists need to respond to this crisis, identifies gaps in the available data, and anticipates barriers to data collection that, if addressed, could enable clinicians and policy-makers to evaluate and improve the value of geriatric prison health care.

SUBMITTER: Ahalt C

PROVIDER: S-EPMC3984258 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

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Paying the price: the pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners.

Ahalt Cyrus C Trestman Robert L RL Rich Josiah D JD Greifinger Robert B RB Williams Brie A BA

Journal of the American Geriatrics Society 20131101 11

Despite a recent decline in the U.S. prison population, the older prisoner population is growing rapidly. U.S. prisons are constitutionally required to provide health care to prisoners. As the population ages, healthcare costs rise, states are forced to cut spending, and many correctional agencies struggle to meet this legal standard of care. Failure to meet the healthcare needs of older prisoners, who now account for nearly 10% of the prison population, can cause avoidable suffering in a medica ...[more]

PMID: 24219203

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Project description:Background:Impaired sleep quality affects judgment, psychomotor skills, memory, decision-making, concentration, and attention. It might also contribute to the development of new physical health problems, as well as exacerbating already existing physical problems. Despite this, there is a scarcity of research done in Africa including Ethiopia that addressed this issue. So this study assessed the quality of sleep and related factors among prisoners of the Diredawa correctional facility, Diredawa, eastern Ethiopia. Methods:A cross-sectional study was done using a simple random sampling technique to recruit 421 participants from May 21 to June 21; 2017. A semi-structured questionnaire, Pittsburgh Sleeps Quality Index (PSFIG), Patient Health Questionnaire-9 (PQ-9), and Sleep Hygiene Index (SHI) were used to assess participants' socio-demographic data, sleep quality, depression, and sleep hygiene, respectively. The collected data were entered into EPA-data 3.1 and analyzed by using SPAS-20. Descriptive and analytical statistics were used. Bivariate and multivariable logistic regression with odds ratio and 95% CI were employed. The statistical significance was declared at p value?<?0.05. Results:A total of 421 out of 423 prisoners were interviewed, resulting in a response rate of 99.5%. The prevalence of poor sleep quality was 227 (53.9%) with 95% CI (49.2, 58.7). Having co-morbidity of depression (adjusted odds ratio; OAR?=?3.47, 95% CI 1.38,8.76), lifetime use of cigarette (OAR?=?2.16, 95% CI 1.21,5.58), marijuana and hashish (OAR?=?5.02, 95% CI 1.63,15.46), current use of coffee (OAR?=?2.75, CI 1.37, 7.05), poor sleep hygiene (OAR?=?3.19, CI 1.32,7.69), committing assault crime (OAR?=?4.12, CI 1.29,10.63) and crime of rape (OAR?=?5.57, CI (1.45, 13.89) were the associated factors for poor sleep quality in this study. Conclusion:More than half of the participants (53.9%) have poor sleep quality. Depression, lifetime use of cigarettes, using cannabis and hashish, current use of coffee, poor sleep hygiene, and crime types were the associated factors that should be taken into consideration and evaluated early to minimize poor sleep quality.

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Dataset Information

Paying the price: the pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners.

Publications

Paying the price: the pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners.

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